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So, I had a lot of comments and questions from friends regarding the last blog. Let’s just say some of my points led to curiosities. My answer, at this point in time, is to just keep reading the blogs and, hey, maybe someday a book may appear in a bookstore or device near you! My initial blogs from several years back were on more plastic surgery topics, and I still may make a few regarding my primary vocation. However, friends have been so interested in my life choices and encouraged my re-starting the series based on those stories. On that note, to answer one inquiry, I had mentioned in the last blog the years pursuant to my father’s passing were the worst, no matter what transpired in the 34 years since his death. What were some of my best years, one asks? I especially chose to write this topic as it is timely to current news. Brooklyn. Those were some of my best years. And, mind you, this is not going to be the last you’ll hear about my Brooklyn experience.

My dream in life in my early 20’s was to move to NYC. I just had this love obsession with that place, and it stemmed from the energy, the people, and diversity that I witnessed on that mystical TV or movie screen. I was raised in Quincy, IL right off of the Mississippi River and was a Midwestern girl. New York, to me, vibrated with intense possibilities and opportunities. Now, I never thought that I would be applying to general surgery programs in New York because I did not grow up thinking I would be a surgeon (you see……..here is an I’m leaving you hang moment). However, when the time came to make a decision in medical school regarding a residency, I applied only to general surgery programs in New York. That was a kind of ballsy thing to do because I had no ties in New York, I’m from the heartland of America, and I just was this petite little 20 something….girl…. with a twang. Moreover, I didn’t get much encouragement because, first of all, general surgery is hard to get into, and second of all, it’s insane that I would want to do any residency in a crowded, busy city at its peak of gang violence and HIV.

Here’s where hard work and perseverance payed off because Gerald Shaftan, MD, FACS gave me the opportunity and accepted me into his program at Brookdale Hospital in Brooklyn, New York. I am forever grateful to him for having faith in my capabilities, and to you, too, Dr. Fogler, I still quote you, btw in the OR, for believing in me. And, you trained and taught me well. So, to give you all a perspective of Brookdale, the hospital is located in East New York, ie Brownsville. You’re scratching your head saying, hmmmmm, that hospital sounds familiar. It did make the news in the last month because of its excessive COVID 19 patient flow resulting in extending a morgue into the parking lot. Brookdale has always been in an underserved area even back in the ‘90s when I did my general surgery residency. However, those were some of my best years because I was excited to be in New York and loved Brooklyn. The area had an extensive ethnic diversity from Latino, African, Caribbean, Caucasian, and on and on with markets and small eateries to reflect the diversity. It was a dangerous gang-ridden area. There were areas that no one could amble into. There were cars on fire and stray bullets. Yet, with the Yin and the Yang of it all and our hard work, we all just got along, and we got along great. We took care of people who, otherwise, would receive no care, and from a newbie’s perspective there was a lot there to provide for learning.

Besides my excitement to finally live in Brooklyn, the fun of those difficult years stemmed from the friendships and interactions that I made. I certainly don’t want to romanticize the time because it was hard riddled with a lot of challenges……..hanging moment for you, reader. That is why, in those difficult situations overwrought with fatigue and more fatigue, the nurses and staff over the six years of my residency became family. This also includes EMS, police, firefighters, and detectives because we worked with everyone. Brookdale is a major Level One trauma center. In addition to the trauma, even then, racial tension existed as it was just after the Crown Heights situation miles away from Brookdale that I started my residency. There were several other major racially tense national events that made news during my residency. Those patients did not make it to Brookdale but all were aware of the iniquities. They were discussed and judgments were made. Most importantly, I owe my perspective on life, not just surgical knowledge, and personal growth to the voluminous patient interactions. As busy as we were, I am grateful that I spent time talking with my patients or their families. You see, none of us are an island, and what I know is the simple fact that no matter what are skin color is, we all share common feelings of fear and insecurity. We all have the same needs of belonging and acceptance. On the inside, literally, with our sterile drapes in the OR, one could not guess one’s Race or Ethnicity. I don’t want to get too graphic but body parts look like body parts independent of the exterior.

My first rotation was the SICU, and I remember, especially, the first day when I walked into the unit because the staff wasn’t used to a female surgical resident and on top of that I wasn’t from the area. We did our rounds as I and the team walked bed to bed reviewing patient history and tasks to be done. Then, my senior residents split without any guidance whatsoever. They vanished and, as we call it, dumped on me and the other two interns. That is when Ms. Williams, from Trinidad, and Lucy from Haiti took me under their wings and started me on my task list one step at a time. Then, Diana from Ghana shared with me her lunch of this delicious chicken/vegetable mix with her homeland’s spices. Later, Rena, a newly married Orthodox Jew helped me with my first arterial blood gas stick. From their perspective, they didn’t know if I was going to be one of those uppity, chip on her shoulder types. I know this because they told me. Then, they told me within five minutes, they knew they liked me because I asked them questions and had manners. I, personally, think it was the deer in the headlights look. They were just too nice to say that to me. This is pretty much how an incredibly difficult residency in an incredibly difficult area went for its entirety. When I look back, I am amazed at just how quick and medically sound those nurses were in very time sensitive situations. They were some of my best teachers. During my last year, one of the orderlies had connections to the local elementary schools in the area. The last year in general surgery is called the “chief” year. As chief resident, I visited those schools weekly to talk with kids from each grade about health-related issues. It was spontaneous and fun. It was the icing on the cake after working in the community for six years. By then, I was able to walk the area because I took care of all comers, they all knew me, and we all got along.

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As you know after reading the last blog, I’m a very busy person. How do I juggle life? Well, for years, I have studied many spiritual teachings one of which is Buddhism. That being said, I’m not a Buddhist or an expert, but I believe many different religions and philosophies offer teachings nourishing to one’s soul. Mindfulness may be considered as a meditative state of self-cognition. Breathing techniques to generate awareness of your body, self and surrounding. Now, forgive me for the oversimplification but there is a real and personal point I want to make with this blog as one who has thought of mindfulness and respects its purpose. You see, for me, mindfulness is giving my 100% to the person with whom I am communicating. At that time, I am not thinking about my phone or pending tasks. Mindfulness guides me to appreciate my current state as I walk through nature or talk with a friend. I am 100% present. This practice, like all spiritual habits did not come without much thought and practice. For, throughout my years of working in areas where people were poor, sick and despondent, I thought how would anyone even think mindfulness would help in that situation? When one experiences painful loss or lives in suboptimal areas, how is mindfulness even expected to help?

When I was 17 years-old, my father died suddenly and tragically. One day I had a father and a small family of five. I only cared about my GPA, SAT, ACT, AT scores and getting into medical school. Then one day, I’m told my father is dead. This was in January of 1986 where I awoke the next day hearing the birds and thinking what a beautiful day for January in Illinois. Then, the reality sunk in that I no longer had a father. So, I ask you, when you are in a situation of true pain, where would one even venture to be mindful? In fact, the present is so painful that you don’t even know how you are going to survive another day.

Well, I did survive because here I am in 2020peripherally writing about dad’s passing. I will write more about his death later. At 17 y/o, I became an adult, and back then, we didn’t talk about mindfulness in the heartland of America. We did talk about Faith and I learned how much friendship is important to one’s life since ultimately the ensuing years it was just my mother and me. My experience gave me insight into real human feelings, life and the good of people as well as the ugly. It would be an easy solution to escape the reality of that pain through drugs, alcohol and other addictions. And, that does happen as one who studies mindfulness learns its role in cognitive therapy to help with addiction. What transpired for me was that I gotaccepted into medical school, and that opened a door to a lifetime of learning about the human condition with empathy. I’m not saying it was a bim bam boom solution to my major grief; those five years, to date, were the most difficult and horrible years of my life. I’ve had many hard years since then but compared to January 30, 1986, the rest of life was just something else to deal with, and I dealt with all simply with Faith. Here is where I end with my point about mindfulness. I make this point because, really, when one reads touchy feely books for healing purposes, sometimes it’s like quit the BS. It can be hard to relate when one really hurts. In fact, some of the points don’t even sink in. However, now, “mindfulness”, back then what I called Faith (well, I still have Faith) means to me that even when life truly sucks, mindfulness will help you focus on the moment where your friends come to you in pure support. Mindfulness will help you relish in the sweetest memories of your father and be grateful for those memories. Mindfulness helps you realize that at this very moment there is a Spirit that will help you through your grief even though you are devasted. Even to this day, when one suffers through tragedy or depression, mindfulness tells you that you, alone, are not the only one who has gone through whatever situation makes you desperate or sad. Somewhere in all of this, no one is alone as we are all members of this thing called the human condition. For that, it is important to be mindful of yourself and others to help you and your loved ones heal.

Dad and me c.1983My prom date, Mike, who succumbed to cancer one year later c.1986

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Memorial Day is just around the corner. However, in our current COVIDcentric world my fear is that this honorable reverence day will fall victim to COVID shadowed by the latest COVID policy, procedure, scandal and who’s who which would be a shame. Memorial Day means a lot to me and to many people. So many young men and women have given their lives so we, as Americans, enjoy our freedoms that include extensive COVID discussions and debate. In addition to the love of my country, my draw to the military started way back in the early ‘70’s. I remember watching the news with my parents and seeing people throw trash and yell insults at these emaciated, withered young men for, to me, no apparent reason. As a 5- year-old child, it didn’t make sense since it was, in my book, poor manners. Mommy and daddy would rebuke me for such behavior. At that time, I couldn’t wrap my head around what I was seeing. My father explained the situation to me as best as he could to a little kid. Somehow the empathy and respect for those young men returning from Vietnam stuck with me for 43 years such that I commissioned into the United States Navy as a medical officer with no prior military experience at 48 years of age. Currently, I’m attached to a Marine Corps Infantry Unit (2/23, the guys of Iwo Jima, ‘Rah) as medical officer/battalion surgeon/OIC. I’ve had a crash course not just in the military culture but also its health care system. So, my dear friends, here is one more new thing in my life that has kept me busy since my prior blog series.

In 2016, I raised my right hand and made an oath to help preserve our Constitutional rights as Americans. I really didn’t know what to expect as it is a totally new way of life that I started, as I mentioned, at 48 y/o. I remember prior to “boot camp”, shopping the required items at Target thinking at the check out line, “Isn’t this crazy? I should be shopping this for my kid (no, I don’t have children, I’m a resource home)…not me!” Well, the “boot camp” in Rhode Island was for two weeks that now has been increased to the usual five-week ODS for my future physician recruits whom I keep nagging. It still was quite an interesting ordeal for a civilian new to military culture. But, especially after now hanging out with Marines for most of my military career thusfar, I cannot complain. I had a warm shower, bed, toilet, and warm food. And……diet Coke. The greatest outcome of this experience was the initial orientation to the many new friends that you make in the military. The people who you otherwise would never cross paths, but for love of country, you have come together and now are family.

I stayed pure Navy for a little over a year, then joined, what we call “green” side or attached to the Marines. The Marines depend on the Navy for medical and chaplain services. So, I’m still a Navy officer but I drill and mobilize with the Marines. Most of you know that I’ve always been athletic or at least work out, but now as a member of the Marine family, I own the work out at a time in my life when really everything hurts. However, I trek out there with my personal favorite being the HIIT and still do the yoga and swim, and, well, I don’t hurt any longer. Which goes to my point, that many of you already know, is my stand that you just gotta work out. After 40, it’s a must if you want to age well and active. In addition to the fitness and the friendships, I’m so impressed with military culture and the discipline of the people around me. The attention to detail, manners and cleanliness, really, that I witness with the military is genuinely admirable as is the enthusiasm to serve our country. I’ve enjoyed meeting and working with my medical colleagues who have shared their war stories. There’s something about seeing your general surgeon colleague choke up upon remembering an IED event leading to the death of a particular corpsman. The corpsmen are a special breed of people. Most of all, I love my corpsmen. They just want to learn and their “can do” attitude is infectious. It was a pleasure working with my corpsmen in Bridgeport last year (picture) where we tirelessly provided medical support to the Marines who were trekking, repelling and jumping out of planes. During our monthly drill weekends, we review combat care cases, and I learn just as much from the corpsmen as they from me. Many of the corpsmen have been out there in Iraq and Afghanistan. They have shared their stories and experiences that generate nothing but the utmost respect from anyone hearing what these corpsmen (and medics) do out there in the actual field setting. Despite my trauma years in Brooklyn in the ‘90’s where I truly thought I had seen it all, I have learned that combat medicine is a different beast all together.

So, to conclude for now until next blog, I know many of you were like, “what are you doing at your age signing up with the Navy and now you’re hanging out with Marines,” but I must say, I am honored to work with such a dedicated group of people. Yes, it is challenging juggling a private surgical practice with this secondary job, but I appreciate my beautiful patient base who allow me to pursue this avenue with their quintessential patience, and I owe it to a great country we call The United States of America. This Memorial Day, I send my love and respect to all MILITARY and THANK YOU for being you.

‘Rah and Semper Fi

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Hi Friends. It has been a while since my last intentionsofbeauty blog. Let’s say about eight years. Much has happened and it has been a long eight years. As I read prior blogs and your responses, I sincerely from my heart want to thank you for taking the time to read my blog and comment. It’s important for me that people know that this blog is directed at my friends or people who just want to read the blog. It is not patient-directed even though some of the topics focus on plastic surgery topics. I just write about these topics because there is something that I feel is important to share with you. Further, this blog is with pure intention to share my life experiences with those of you about whom I care mucho.

Some of you know, many of my very dear friends, including my mother are now in spirit form. Last year, I lost many friends, just very dear people in my life such that I want to dedicate this blog rebirth to them. However, the incident that blocked my writing voice was witnessing my mother’s extensive stroke, the two-year aftercare, and her passing. As we Gen X’rs know, we fall into that population where we care for parents, children and all others. Now, to catch you up on the kid thing, yes, I did do foster work for SCC but that will be for another blog. Like I said, it’s been a long and busy eight years. Mom’s dementia progressed into that fateful night that led her to the hospital. It was there, in the hospital, that I witnessed her grand mal seizure while she was on blood thinners that started the two- year journey of intensive home care for mom. There is much to the story like many things that I will share over time but the big take-home message was exactly that: when mom… who was right side paralyzed, could not talk and sort-of understood things, was fed through a stomach tube….came home, I was able to care for her with the help of our dear friend/family Suzanna until mom’s passing. During this difficult time, I learned the true value of my dear friends, patients and perfect strangers who stuck by me. I am forever grateful. Mom peacefully passed in the hospital while holding my hand listening to my prayers. My nurse and respiratory therapy friends who helped me through this will never be forgotten.

We are all going through some challenging times with this COVID situation. I hope all of you are reaching into your heart and souls to find that place that brings you peace. And, though we are in social isolation, we are all together in thoughts that we must keep positive if we want to overcome COVID and its repercussions. For me, in addition to my friends and all the wonderful things that Spirit has given me, I have my animals. To date, I have 2 dogs, 4 cats and 2 parakeets all of whom are rescues except for the parakeets. Milo and Mila, my dogs, are older rescues. I share my little pet family because they have made this time so much easier for me. There are two pictures in this blog that I want to share. The first demonstrates the sweet intuitiveness of dogs. Milo, who was six when I adopted him, came home for the first time and the first thing he did was jump into bed with mom. I love this picture. She looks a little dazed because Milo took her off guard; somewhere in the next few blogs I’ll share some more “happy” mom pictures. But, that boy just ran straight from my door into her bed knowing where healing is needed. Speaking of healing, here is a picture of my boys Milo and Luigi sharing some love with their momma. Who said that all species can’t get along? In my house, we live in peace just fine and hope the same for all of you. With that, I wish all of you good health and safety. Send all of you virtual hugs.

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Did all of you have a loving Valentine’s Day? I sure hope so. Valentine’s Day is my favorite holiday because it makes us reflect on that four-letter word—“LOVE.” I know most of us equate the day with flowers, chocolate and romantic love. But how about the concept of universal love switching the focus from self to how we are all connected in one way or another?
I spent some of my Valentine’s weekend attending the annual San Francisco Writer’s University conference. One of the keynote speakers was the lovely Ann Perry who speaks as graciously as she writes. She so enthralled me with her comments and philosophy about her writing. One comment she made, responding to the question of why she gives her subordinate characters importance, struck such a chord with me. She simply stated, “Every human being is important. Whether they are a primary or secondary character is not important because every human life is important.” I’m always amazed the number of drafts that go into the final writing product. When, I read an engaging book by great writers like Ann Perry, with steady pace, character development and sensual description, I think that it just happens when pen hits paper. She, as well, as many others admitted to the hard work and number of drafts that go into the final product that, we as the reader, so enjoy. I thought to myself, as I was listening, that maybe we, as human beings, should view life as drafts. Most spiritual literature discusses the many deaths and rebirths or should I say phases that occur in a person’s life. As we progress through life analyzing our thought process as it relates to our reality and sense of happiness and accomplishment, meditating on those concepts that become more lucid should be our goal. Each phase should build upon and improve the next for what we present to our Spirit (God, Christ, etc……whatever your faith may be) our last and final draft. For those who do not reflect or simply care not to examine their life, well, let me just put it this way……it’s not for me to judge, and I pray for you. An outlook as such may not be so depressing for those who view aging as a horrific event. After all, with age, does come wisdom to those who pursue finding their Spirit. And I can only see Spirit as a loving, caring Spirit who loves all of us whether we are primary or secondary characters. Happy Valentine’s Day.

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Thanks to all of you who expressed missing my blog and where did I go? Some of you know that I’m working on a major writing project that takes up much of my precious writing time. But, I am appreciative to those of you asking me to resume my blog, so here we go. Well, it’s another new year and time for resolutions. I have a suggestion: how about a resolution of self-acceptance and, here we go, self-love.

Resolutions come from a place within us that awakens our inner critic. We’re too fat because we don’t eat right or exercise. We are morons who can’t spend our money correctly. We can’t succeed at x because we are not y. Get my point? Especially, the more “Type A” we are the more geared we are to critique those around us, and, most all, ourselves. Also, these are downer times where many people are feeling anxiety and uncertainty about the future.

We all have our chosen successes and failures in our lives. Whether it’s a daily routine or a goal that we feel we must achieve but haven’t, we tend to focus on “failures” hence our society’s omnipotent and highly popular resolution concept. Sometimes failures are highlighted because people around us love to focus on and gossip about these things……especially, in the competitive milieu. What self-acceptance/self-love do is not make us lazy and say to hell with it, this is the way it is. Rather, instead of negative thoughts, self-acceptance brings on the energy of focusing on the good about ourselves and then, if there’s something we want to change approach our inner critic with the “ by the way, there’s something I’d like to improve upon and let’s give it a whirl” attitude. My best example that I can think of comes from sports. We all have favorite teams and athletes. There are times, for example, that I watch Derrick Rose (Chicago Bulls MVPx3) who is amazing most of the time. However, even Derrick misses a key lay up or free throw that costs the team a game. I’m sure he, his teammates and coach (Oh! And let’s not forget the people who bet on the game, the team owner and manager and the whole state of IL) slam him. Outside of his not playing a game this season because of his ACL issue, does he throw in the towel? NO!!!! He knows he’s good, we know he’s good and he just goes back and tries his best.

My closing thought to you is to be kind to yourself. Life is hard, but guess what? We’re all in this together and if we’re kind to self and accept self, collectively, we’re kind and accept each other

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Really, guys, I intend to inform you about that great ASPS meeting on complications that I attended back in July. But, with the last blog, I got some great feedback and comments. Yes, I did leave the conclusion open-ended. Why? Because, none of us know what’s going on and what the future entails for all of us: physicians, businesses, insurance companies and, most importantly, patients. The trend from a universal healthcare and cost standpoint is the conglomerate health care system or group practice. There is a subtle implication in the previous blog that the solo physician, like me, in private practice may be of historical value in the next few years. I think that it is a sad state of affairs, because I, personally, love my patient base, and, in addition to the medical treatment, enjoy getting to know my folks. Most of us our going to hang in there the best we can. That being said, I also believe that the leadership and physicians of groups like Kaiser, PAMF, etc. are trying their best to provide the best healthcare as possible. Same goes for hospitals like ValleyMedicalCenter that provide service to the uninsured. We’re all caught up with desire to provide excellent care as proud citizens of the USA; however, our financial hands tied.

What is known is there is a problem residing on the multitude of people who are losing their health care benefits because of the anemic economy. For those who have insurance, we physicians are having an even more difficult time getting tests or procedures authorized. Finally, the uncertainty, changes and increase cost create a general frustration amongst the people. People are justifiably scared because we, as Americans, simply aren’t used to uncertainty. The American way is fertile with ingenuity, possibility and hope.

Let’s see what the future holds and put our creative minds together for a do-able solution. We are all in this together and need to remember that and work together in a positive fashion.

On that note, next blog I’ll talk about different body shapes. ‘Til then, be well, my friends.